This study is to determine the effectiveness of photochemotherapy to prevent rejection on a long term basis in heart transplant recipients who are highly sensitized or with refractory cardiac rejection. A total of four patients have been treated with photochemotherapy after heart transplantation. All but one are alive and well without complications from the treatments themselves. The one patient who died, did so five days after surgery. The patient was not receiving photochemotherapy at the time of death. The cause of death remains unknown and was not related to the photochemotherapy procedure.